When Can We Declare the Pandemic Over?

Normal has never meant “perfectly safe.” A safer world will likely still have Covid-19 in it. Credit Ashley Gilbertson/VII for The New York Times
Normal has never meant “perfectly safe.” A safer world will likely still have Covid-19 in it. Credit Ashley Gilbertson/VII for The New York Times

During the pandemic, good management and guidance have often been lacking. If we want to make our exit from the crisis better than our entrance and passage through it, we’ve got to start planning now. A good first step would be to agree on our definition of an ending.

When can we declare the pandemic over?

Not yet, of course. Cases are stalled or rising in many areas. Virus variants are becoming more prevalent. While many people are vaccinated, many more are not. Hospitalizations and deaths are still occurring, especially in those groups not yet fully immunized. Community spread is far too rampant, and risks still abound. Recently the director of the Centers for Disease Control and Prevention, Dr. Rochelle Walensky, warned of “impending doom” from a fourth surge if we aren’t careful.

But things are significantly better than they were a few months ago. As we continue to improve, it would be useful to have guidance on how we might ease the policies that have kept us protected.

Too many people, though, are unwilling to talk about any lowering of our guard — even in the future — because some danger still exists. They want to know that no one is dying of Covid-19 in their community anymore, or they want to know that there are no cases in the area and that there is no chance of their being exposed.

I understand the sentiment, as we have been overwhelmed with messaging about how dangerous Covid-19 is. But the sentiment is not realistic, nor is it reasonable. Such extreme vigilance can also backfire: Each day we wait, more people become impatient and abandon their posts.

Normal has never meant “perfectly safe.” A safer world will likely still have Covid-19 in it.

Ideally, we should reduce restrictions gradually while we closely monitor the situation. First, we might liberalize outdoor gatherings and open schools and maybe even camps more fully. If all goes well, we could allow for denser indoor public events, with masks. We could allow restaurants and bars to increase to full capacity in stages.

While we do all this, we should track cases, hospitalizations and positivity rates. We will still need to test widely, even asymptomatic people, to measure our progress. Should all go well, eventually, we could get rid of masking requirements. If enough people are vaccinated and transmissions slow, we will reach a place where we are much, much safer than we are now.

Americans are generally willing to live with a greater-than-zero level of risk in exchange for what we used to consider a normal life. The roads are full of cars, even though accidents are the No. 1 killer of children. We don’t seem that eager as a country to restrict access to guns, even though they cause injuries or deaths every day. Bottom line: We can sometimes collectively act to reduce risk, but we almost never eliminate it.

That doesn’t mean that public health officials should stop pushing for the best outcome. That’s their job. When the risk is immediate and severe, as it has been for the past year, we pay close attention, as we should. But when the risk is lower and the gain more incremental, we often don’t.

On the one hand, I’ve written extensively on how the C.D.C.’s advice on salt and alcohol can feel excessive and how the World Health Organization thinks seemingly everything causes cancer. On the other, I think Americans don’t take those groups seriously enough when it comes to the flu. Others may disagree. The important thing for people to do is to strike a balance between the ideal and the doable.

The danger from Covid-19 is still great enough in some places that we need to be vigilant. But if we can get the pandemic to a point that a vast majority of people who become sick get well, that the number of people who are hospitalized and dying is low and that this really isn’t any worse than your average seasonal respiratory virus, then it’s time to start seriously relaxing our restrictions.

Well over 100 people die of influenza in the United States on an average day in a typical flu season, but that figure doesn’t approach the alarming numbers from Covid-19. We aren’t close to eliminating that gap, but it’s absolutely possible as vaccination increases. We can’t be afraid to set benchmarks on our way there for the gradual relaxation of guidelines. Announcing goals and expectations will give Americans something to shoot for and a reason to hold fast for now.

Of course, it would be welcome if we could learn from this experience and set a new normal. If people want to remain more vigilant in the coming years and stay home when sick, mask up when they have a cough or other cold symptoms, wash their hands more often and get vaccinated every year, I’d be all for it. It would save lives from Covid-19, and it would greatly reduce the morbidity and mortality from other infectious diseases as well.

Aaron E. Carroll is a contributing Opinion writer. He is a professor of pediatrics at Indiana University School of Medicine and the vice president for faculty development at the Regenstrief Institute who blogs on health research and policy at The Incidental Economist.

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